Hemocoagulative Modifications after Laparoscopic Surgery at Different Pneumoperitoneum Pressure Settings

Intagliata, Eva; Vecchio, Rosario; Saitta, Cesare; Clarissa, Vizzini; Federica, Lo Presti; Rosaria, Cacciola Rossella; Cacciola, Emma; Vecchio, Veronica

doi:10.29337/ijsp.173

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Patients with coronary artery disease, chronic hypertension, and other conditions are extremely sensitive to changes in left ventricular afterload [23] . CO 2 pneumoperitoneum can also slow blood ow, increase viscosity, and cause microtears in the vascular endothelium, which promotes the formation of venous thrombosis [24] . On the other hand, CO 2 pneumoperitoneum causes hypercapnia, acidosis, and a 20% decrease in stroke volume at normal blood volume, and this more pronounced with moderate blood loss [25] .…”

Section: Resultsmentioning

confidence: 99%

Gasless vNOTES vs traditional vNOTES for benign gynecological disease: a randomized controlled clinical trial

Wang,

Liu,

Gong

et al. 2024

Preprint

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Background: Gasless transvaginal natural orifice transluminal endoscopic surgery (G-vNOTES) can avoid complications related to pneumoperitoneum, but there is limited research on G-vNOTES. Here, we aimed to compare the hemodynamic profiles and outcomes of G-vNOTES with traditional vNOTES in the treatment of patients with benign gynecologic disease. Methods: A total of 120 patients with benign gynecologic disease were randomly assigned to G-vNOTES (n=60) or traditional vNOTES (n=60). The primary outcome was vital sign at different time points. Secondary outcomes included conversion rate, surgical time, anesthesia time, the usage of anesthetics, estimated intraoperative blood loss, visual analogue scale (VAS) score for abdominal and shoulder pain and postoperative nausea and vomiting (PONV) at 2 and 24 hours, intraoperative and postoperative complications, time to first anal exhaust, eating, and getting out of bed after surgery, and length of postoperative hospital stay. Results: There was no significant difference between the two groups at the baseline level. The results of the multi-level model indicate that the PetCO2 of the G-vNOTE group is lower than that of the T-vNOTES group (p=0.024). The conversion rate in the G-vNOTES group was higher than that in the G-vNOTES group (16.95% vs 5.26%, p=0.046). No significant differences were observed in other areas. Conclusions: The PetCO2 in the G-vNOTES group was lower than that in the T-vNOTES group, which may be more beneficial for the treatment of patients with concomitant cardiovascular and pulmonary diseases. The surgical conversion rate of the G-vNOTES group is higher than that of the G-vNOTES group, which may be related to poor surgical field exposure in the G-vNOTES group, making it more suitable for experienced and confident surgeons.

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Section: Resultsmentioning

confidence: 99%

Gasless vNOTES vs traditional vNOTES for benign gynecological disease: a randomized controlled clinical trial

Wang,

Liu,

Gong

et al. 2024

Preprint

View full text Add to dashboard Cite

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A Study of Alteration in Coagulation Profile in Patients Undergoing Laparoscopic Cholecystectomy

Das¹,

Chelleng²,

Ajith³

2022

ijsr

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Introduction: Laparoscopic cholecystectomy has become the gold standard for the treatment of cholelithiasis. It has many advantages such as better cosmetic, shorter hospitalization time, minimal postoperative pain, early return to normal life. However carbon dioxide pneumoperitoneum may cause alteration in the coagulation system and moreover the reverse Trendelenburg position adopted diring surgery can induce blood stagnation in the lower limbs leading to a hypercoagulable state. The aim Objective: of the study was to record the effect of carbon dioxide pneumoperitoneum on coagulation factors and brinolysis response during laparoscopic cholecystectomy and to assess if there is any risk of postoperative thromboembolic complications following laparoscopic cholecystectomy. Methods: The hospital based descriptive study of 50 patients undergoing elective laparoscopic cholecystectomy was designed to study alteration in Clotting time, Prothrombin time(PT), Activated partial thrombin time(aPTT), Fibrinogen and D-dimer, which were measured preoperatively and 6 hour postoperatively. Out of 50 Results: patients operated 38 were female and 12 were male. Signicant decrease in PT and aPTT suggested activation of coagulation pathways while signicant increase in d-dimer and brinogen suggested activation of brinolytic systems. None of the patients had any postoperative thromboembolic complications. From the study we found that there was activati Discussions: on of coagulation and brinolysis after laparoscopic cholecystectomy leading to a hypercoagulable state which may be either due to carbon dioxide pneumoperitoneum or due to increased intraabdominal pressure. Although none of the patients had any thromboembolic complications postoperatively, however there may be the need to use prophylactic measures for thrombosis in high risk patients.

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Hemocoagulative Modifications after Laparoscopic Surgery at Different Pneumoperitoneum Pressure Settings

Cited by 2 publications

References 18 publications

Gasless vNOTES vs traditional vNOTES for benign gynecological disease: a randomized controlled clinical trial

Gasless vNOTES vs traditional vNOTES for benign gynecological disease: a randomized controlled clinical trial

A Study of Alteration in Coagulation Profile in Patients Undergoing Laparoscopic Cholecystectomy

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